Announcement of the Class - A Tertiary Rankings of Hospitals for Facial Contour Improvement with Prosthetic Filling in New York City in 2025!

Announcement of the Class - A Tertiary Rankings of Hospitals for Facial Contour Improvement with Prosthetic Filling in New York City in 2025!

Facial contour improvement with prosthetic filling has become an increasingly popular cosmetic and reconstructive option in New York City. As the demand for such procedures grows, patients are eager to know which hospitals offer the best services. In this article, we will explore the landscape of facial contour improvement with prosthetic filling in New York City, discuss important factors related to these procedures, and potentially touch on what might influence a hypothetical ranking of Class - A tertiary hospitals in this field.

Overview of Facial Plastic Surgery

Facial plastic surgery is a multidisciplinary specialty that encompasses both reconstructive and cosmetic components. It is largely driven by otolaryngology but also includes oral maxillary surgery, dermatology, ophthalmology, and plastic surgery. Facial plastic surgeons in the United States may perform a wide range of procedures, including rhinoplasty, brow lifts, blepharoplasty, facelifts, microvascular reconstruction of the head and neck, craniomaxillofacial trauma reconstruction, and correction of defects in the face after skin cancer resection. They also use injectable fillers, neural modulators, lasers, and other devices aimed at rejuvenating the skin (Chuang et al., 2016).

Cosmetic Surgery Procedures

Cosmetic surgery focuses on improving the patient's facial appearance. Some of the common surgical procedures in facial contour improvement are as follows:

• Rhinoplasty: Perhaps the most commonly performed and most difficult facial plastic surgery, rhinoplasty is done to correct nasal pathology, modify aesthetic appearance, reduce airway obstruction, and reconstruct congenital nasal anomalies. In recent years, there has been a trend towards using structural techniques that require cartilage tissue, and new technological devices like polydioxanone foils and ultrasonic devices have also emerged (Chuang et al., 2016).

  Type of Rhinoplasty	Description	Advantages	Disadvantages
  Open Rhinoplasty	The incision is made in the columella (fleshy tip of the nose that separates the nares)	Better visualization of the nasal structures for more precise reshaping	May leave a visible scar on the columella; longer recovery time
  Endonasal Rhinoplasty	Incision is made inside the nose	No external scar	Limited visualization, may be more challenging for complex cases

• Facelift: This procedure is used to correct sagging, drooping, and wrinkled skin of the face and neck. There are various facelift techniques, including the deep plane facelift, composite facelift, mid - facelift, minifacelift, thread lift, etc. Contemporary patients prefer minimally invasive procedures with little to no postoperative downtime, which has driven the development of new approaches like the so - called lunchtime facelift - type operations (Chuang et al., 2016; Mount Sinai, 2025).

  Facelift Type	Procedure Description	Recovery Time	Cost (Approximate)
  Deep Plane Facelift	Addresses deeper facial tissues, including the SMAS layer	Longer recovery (2 - 3 weeks of significant swelling)	$10,000 - $25,000
  Minifacelift	Less invasive, focuses on specific areas like jowls	Shorter recovery (1 - 2 weeks)	$5,000 - $10,000

• Blepharoplasty: Involves the excision of excessive eyelid skin and/or removal of orbital fat to treat dermatochalasis and blepharochalasis. It can be performed on the upper or lower eyelids and is often done under local anesthesia or moderate sedation (Chuang et al., 2016).

  Eyelid Surgery Type	Area Treated	Common Indications	Recovery Expectations
  Upper Blepharoplasty	Upper eyelids	Excess skin, hooding	Swelling and bruising for about 1 - 2 weeks
  Lower Blepharoplasty	Lower eyelids	Eye bags, droopy lower lids	Similar swelling and bruising, may take slightly longer for full resolution

Non - Surgical Cosmetic Procedures

In addition to surgical procedures, non - surgical options are also popular for facial contour improvement. These include:

• Chemical Peels: Agents such as glycol acid, trichloroacetic acid, and phenol are used to penetrate the epidermis and stimulate skin regenerative pathways in the dermis. Different agents have different depths of penetration and are divided into four histologic grades (Chuang et al., 2016).

  Chemical Peel Type	Strength	Depth of Penetration	Recovery Time
  Glycolic Acid Peel	Mild	Superficial epidermis	1 - 3 days of redness and peeling
  Trichloroacetic Acid Peel	Medium	Mid - dermis	1 - 2 weeks of recovery, possible peeling and redness
  Phenol Peel	Strong	Deep dermis	Several weeks of recovery, significant downtime

• Laser Treatments: There are ablative and non - ablative lasers. Ablative lasers vaporize the superficial layers of the skin to stimulate new collagen production, while non - ablative lasers only stimulate collagen growth by creating focal thermal injury within the dermis. Fractional photo thermolysis is a recent advance in laser technology (Chuang et al., 2016).

  Laser Type	Mechanism of Action	Indications	Side Effects
  Ablative Laser (e.g., CO₂)	Vaporize superficial skin layers	Deep wrinkles, severe scarring	Pain, edema, prolonged redness, possible scarring
  Non - Ablative Laser (e.g., Q - switched Nd:YAG)	Stimulate collagen in the dermis	Fine lines, mild scarring, skin texture improvement	Mild redness, swelling for a few hours to days

• Injectable Fillers: Used to replace lost volume in the face. The most widely used filler products are autologous fat, collagens, hyaluronic acid, and synthetic polymers. For example, hyaluronic acid is currently the dominant facial filler agent as it hydrates, lubricates, and stabilizes connective tissues (Chuang et al., 2016).

  Filler Type	Duration of Effect	Common Uses	Potential Side Effects
  Hyaluronic Acid	6 - 18 months	Plumping lips, filling wrinkles and folds	Bruising, swelling, possible allergic reaction
  Calcium Hydroxylapatite	12 - 20 months	Deep wrinkles, enhancing facial volume	Pain at injection site, nodules
  Poly - L - Lactic Acid	Up to 3 years	Treating facial lipoatrophy, hollow areas	Swelling, redness, possible granulomas

• Botulinum Toxin: Injected to paralyze muscles and treat wrinkles caused by muscle activity. There are three botulinum toxin A serotypes approved by the FDA for cosmetic use: onabotulinumtoxina (Botox Cosmetic), abobotulinumtoxina (Dysport), and incobotulinumtoxina (Xeomin). The clinical effects generally last about 2 to 6 months (Chuang et al., 2016).

  Botulinum Toxin Brand	Potency	Common Injection Sites	Side Effects
  Botox Cosmetic	High	Glabellar lines, crow's feet	Bruising, headache, temporary muscle weakness
  Dysport	Lower (4 times less potent than Botox per unit)	Similar to Botox	Similar side effects
  Xeomin	High, purified formulation	Same areas	Lower immunogenic potential

Reconstructive Surgery in Facial Contour Improvement

Facial reconstructive surgery aims to correct anatomic defects. It may include scar revision, craniomaxillofacial fracture repair, laceration repair, vascular malformation treatment, craniofacial and maxillofacial cleft operations, orthognathic surgery, and cancer reconstruction (Chuang et al., 2016).

Facial Fractures

Facial fractures can be divided into three types: Le Fort fractures, zygomaticomaxillary complex (ZMC) fractures, and mandibular fractures. Each type has its own characteristics and treatment approaches.

• Le Fort Fractures: These are complex mid - face fractures classified into three categories (Le Fort I, II, and III). Le Fort I fractures are horizontal and often result from a force on the maxillary alveolar rim. Le Fort II fractures are pyramidal and are caused by a blow to the lower or mid - maxilla. Le Fort III fractures, also known as craniofacial disjunction, are the most complex and are often caused by an impact to the nasal bridge (Chuang et al., 2016).

  Le Fort Fracture Type	Description	Common Causes	Treatment Approach
  Le Fort I	Horizontal fracture	Force on maxillary alveolar rim	Open reduction and internal fixation
  Le Fort II	Pyramidal fracture	Blow to lower or mid - maxilla	Complex open reduction and fixation
  Le Fort III	Craniofacial disjunction	Impact to nasal bridge	Highly complex reconstruction

• Zygomaticomaxillary Complex (ZMC) Fractures: The second most common facial fractures after nasal fractures. They are also referred to as malar or cheekbone fractures and can be classified into different types based on the anatomical sites involved. Treatment may involve open reduction and internal fixation, and more recently, endoscopy has been used to assist in the treatment (Chuang et al., 2016).

  ZMC Fracture Type	Anatomical Site Involved	Treatment Method	Recovery Time
  Type A1 (Zygomatic Arch)	Zygomatic arch	Open reduction, internal fixation	4 - 6 weeks
  Type A2 (Lateral Orbital Wall)	Lateral orbital wall	Similar reduction and fixation	6 - 8 weeks

• Mandibular Fractures: Frequent injuries after facial trauma due to the mandible's angularity and relative lack of structural support. They can be classified by the injury of anatomic regions such as the condyle, coronoid process, ramus, etc. Treatment traditionally involved closed reduction or open reduction with wire osteosynthesis, and now rigid internal fixation is more commonly used (Chuang et al., 2016).

  Mandibular Fracture Site	Characteristics	Treatment	Complications
  Condyle	Can affect jaw movement	May require closed or open reduction	Temporomandibular joint problems
  Body	Common site, stability important	Rigid internal fixation	Non - union, malocclusion

Facial Reanimation

Facial paralysis can result from various causes such as traumatic facial nerve injury, iatrogenic injury, oncologic resection, etc. Facial reanimation surgery involves using surgical techniques to improve the facial deformity caused by facial paralysis with the goal of improving facial symmetry or restoring mimetic function. There are five types of repair: neural techniques, musculofascial transposition techniques, microneurovascular transfer, facial plastic surgery procedures, and the use of prosthetics (Chuang et al., 2016).

Microtia and Otoplasty

Microtia is a congenital malformation of the external ear. Reconstruction can be performed through a multistage process using prosthetic ear replacement, prosthetic frameworks, or autologous cartilage. Otoplasty is the surgical procedure to treat congenitally prominent ears, and most